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34 records – page 1 of 4.

Active or passive immunization in unexplained recurrent miscarriage.

https://arctichealth.org/en/permalink/ahliterature57396
Source
J Reprod Immunol. 2004 Jun;62(1-2):41-52
Publication Type
Article
Date
Jun-2004
Author
Ole B Christiansen
Henriette S Nielsen
Bjorn Pedersen
Author Affiliation
Fertility Clinic 4071, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. obc@pregnancyloss.dk
Source
J Reprod Immunol. 2004 Jun;62(1-2):41-52
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Abortion, Habitual - immunology - prevention & control
Case-Control Studies
Female
Humans
Immunization, Passive
Immunoglobulins, Intravenous - therapeutic use
Lymphocyte Transfusion
Pregnancy
Pregnancy Rate
Vaccination
Abstract
Controversy exists as to whether active immunotherapy with allogeneic lymphocyte transfusions (ALT) or passive immunotherapy with intravenous immunoglobulin (IvIg) improve the chance of live birth in women with unexplained recurrent miscarriages (RM). Meta-analyses of the placebo-controlled trials carried out as Cochrane reviews have concluded than none of the different forms of immunotherapy has proved effective in the total RM population. However, the included trials have generally been small and very heterogenous with respect to the clinical histories of patients and the immunization protocols. Thus, other meta-analyses which have looked at the efficacy in subgroups of RM patients have reported that ALT and IvIg may be effective in women with primary RM and secondary RM, respectively. In RM clinics in Denmark, ALT with donor lymphocytes or IvIg immunotherapy have been tested in several placebo-controlled trials since 1986 in which greater doses than used in other trials have been administered, and both treatments are now used for routine therapy. Our results have convinced us that using the correct immunization protocols on the right subsets of RM patients is effective, but we admit that new placebo-controlled trials focusing on subsets of RM patients are now urgently needed. Furthermore, treated patients should be extensively monitored for changes in a series of immune parameters that may predict pregnancy success and be of importance for our understanding of the mechanisms of action of immunotherapy in RM.
PubMed ID
15288180 View in PubMed
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Alloimmunization in pregnancy during the years 1992-2005 in the central west region of Sweden.

https://arctichealth.org/en/permalink/ahliterature92492
Source
Acta Obstet Gynecol Scand. 2008;87(8):843-8
Publication Type
Article
Date
2008
Author
Gottvall Tomas
Filbey Derek
Author Affiliation
Department of Obstetrics and Gynecology, University Hospital, Orebro, Sweden. tomas.gottwall@lio.se
Source
Acta Obstet Gynecol Scand. 2008;87(8):843-8
Date
2008
Language
English
Publication Type
Article
Keywords
Adult
Catchment Area (Health)
Cohort Studies
Erythroblastosis, Fetal - prevention & control
Female
Humans
Immunization, Passive - utilization
Immunoglobulins, Intravenous - therapeutic use
Immunologic Factors - therapeutic use
Isoantibodies - therapeutic use
Plasma Exchange
Pregnancy
Retrospective Studies
Rh Isoimmunization - prevention & control
Rho(D) Immune Globulin - therapeutic use
Sweden
Abstract
OBJECTIVES: To study the incidence of red cell immunization and to evaluate the use of low-risk invasive procedures in the management of alloimmunized during pregnancy. DESIGN: A 14-year retrospective study of all immunized mothers and their newborns. Population. All reported alloimmunizations between the years 1992 and 2005 in our catchment area were examined. METHODS: Background factors, maternal antibody classification, antibody titers, anti-D quantitation, procedures and maternal treatments instituted during pregnancy, fetal outcome and treatment of the newborn were evaluated. RESULTS: There were 78,145 deliveries in the region. Alloimmunization during pregnancy was detected in 0.4% of all pregnancies, excluding ABO immunizations. A significant alloimmunization (titer level > or =8) was detected in 0.16%. Anti-D immunizations were responsible for 60% of significant immunizations followed by anti-Fy(a) in 10%, anti-c in 7% and anti-K in 4%. Maternal plasma exchange and high-dose intravenous immunoglobulin were used as low-risk invasive treatments in 12 cases. Delivery was in > or =38 weeks in 93% of cases. Twenty-nine newborns were treated with exchange transfusions (ETs) after delivery, whereof 21/29 were due to anti-D, seven due to anti-c and anti-E and in one case anti-Fy(a). No deaths occurred due to severe alloimmunization. CONCLUSION: Anti-D still accounts for the most severe immunizations and for most of the cases where ET was necessary. Low-risk invasive techniques to evaluate and treat pregnancies complicated by alloimmunization seem possible and accurate, avoiding invasive procedures that may exacerbate the immunization during pregnancy.
PubMed ID
18704776 View in PubMed
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Changes in intravenous immunoglobulin prescribing patterns during a period of severe product shortages, 1995-2000.

https://arctichealth.org/en/permalink/ahliterature173002
Source
Vox Sang. 2005 Oct;89(3):150-60
Publication Type
Article
Date
Oct-2005
Author
J M Pendergrast
G D Sher
J L Callum
Author Affiliation
Canadian Blood Services, 67 College Street, Toronto, Ontario, Canada M5G 2M1. jacob.pendergrast@utoronto.ca
Source
Vox Sang. 2005 Oct;89(3):150-60
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Banks
Canada
Data Collection
Drug Prescriptions - statistics & numerical data
Drug Utilization - statistics & numerical data - trends
Drug Utilization Review
Female
Guideline Adherence
Humans
Immunoglobulins, Intravenous - therapeutic use
Male
Middle Aged
Pharmacies
Physician's Practice Patterns - statistics & numerical data - trends
Retrospective Studies
Abstract
Canadian consumption of intravenous immunoglobulin (IVIG) has increased dramatically since it was first marketed in the early 1980s, and Canada is now the world's largest per capita consumer. During the late 1990s, worldwide product shortages of IVIG occurred. This study was designed to identify the disease conditions for which IVIG was being prescribed in academic hospitals during this period, and to explore the effects that IVIG shortages had on prescribing patterns.
Blood bank and pharmacy records of IVIG distribution were collected retrospectively from four Toronto teaching hospitals for the period 1995-2000. These records were then cross-referenced with patient medical records to determine the indication for IVIG administration.
A total of 100,208 g of IVIG was prescribed to 429 patients over a 6-year period. Most of the IVIG consumption was in patients with haematological (22%) or neurological (20%) conditions, in recipients of bone marrow transplants (19%) and in patients with infectious disease-related conditions (including congenital and acquired hypogammoglobulinaemia, 18%). Dermatological conditions (7%) were the most rapidly growing indication for IVIG usage during the 6-year period of review, increasing from 0% of annual IVIG usage in 1995 to 16% in 2000. Over 80% of the diseases treated were supported by published recommendations. After 1997 there was an abrupt decline in the annual number of patients treated, primarily owing to a decline in single-use recipients. Annual consumption of IVIG, however, remained stable.
IVIG shortages were followed by a decrease in the number of single-use recipients, who probably represented empirical use of IVIG; this had little effect on the total amount of IVIG distributed annually. Stricter adherence to currently available published recommendations may not be the optimal means of controlling IVIG use within an academic hospital setting. Rather, emphasis may be better placed on improving the evidence base upon which these recommendations are made, for example by conducting controlled prospective clinical trials.
PubMed ID
16146507 View in PubMed
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Chronic inflammatory demyelinating polyradiculoneuropathy: in a remote northern Ontario hospital.

https://arctichealth.org/en/permalink/ahliterature114740
Source
Can Fam Physician. 2013 Apr;59(4):368-71
Publication Type
Article
Date
Apr-2013
Author
Taryn Taylor
Author Affiliation
Carleton Sports Medicine Clinic, 1125 Colonel By Dr, Ottawa, ON K1S 5B6. taryntaylor13@yahoo.com
Source
Can Fam Physician. 2013 Apr;59(4):368-71
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Aged
Electromyography
Glucocorticoids - therapeutic use
Humans
Immunoglobulins, Intravenous - therapeutic use
Immunologic Factors - therapeutic use
Male
Ontario
Physical Therapy Modalities
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis - physiopathology - therapy
Prednisone - therapeutic use
Rural Health Services
Notes
Cites: J Neurol Neurosurg Psychiatry. 1999 May;66(5):677-8010209187
Cites: Curr Opin Neurol. 2005 Jun;18(3):273-815891411
Cites: Eur J Neurol. 2006 Apr;13(4):326-3216643309
Cites: Curr Neurol Neurosci Rep. 2007 Jan;7(1):63-7017217856
Cites: Neuromuscul Disord. 1996 Oct;6(5):311-258938696
Cites: Ann Neurol. 1994 Dec;36(6):838-457998769
Cites: J Neurol. 1995 Mar;242(4):252-37798127
Cites: Eur J Neurol. 2010 Mar;17(3):356-6320456730
Cites: Neurology. 2003 Apr 1;60(8 Suppl 3):S2-712707416
Cites: J Neurol Sci. 2001 Feb 15;184(1):57-6311231033
Cites: QJM. 1995 Jul;88(7):493-5027633875
PubMed ID
23585604 View in PubMed
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Clinical course of children with immune thrombocytopenic purpura treated with intravenous immunoglobulin G or megadose methylprednisolone or observed without therapy.

https://arctichealth.org/en/permalink/ahliterature31529
Source
Pediatr Hematol Oncol. 2002 Jun;19(4):219-25
Publication Type
Article
Date
Jun-2002
Author
Feride Duru
Tunc Fisgin
Nese Yarali
Abdurrahman Kara
Author Affiliation
Department of Pediatric Hematology, Dr. Sami Ulus Children's Hospital, Ankara, Turkey. ferideduru@superonline.com
Source
Pediatr Hematol Oncol. 2002 Jun;19(4):219-25
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Anti-Inflammatory Agents - therapeutic use
Blood Platelets - drug effects - immunology
Child
Child, Preschool
Comparative Study
Female
Humans
Immunoglobulins, Intravenous - therapeutic use
Infant
Male
Methylprednisolone - therapeutic use
Platelet Count
Purpura, Thrombocytopenic, Idiopathic - immunology - therapy
Remission Induction
Treatment Outcome
Abstract
The authors compared the prognosis in 50 children with acute immune thrombocytopenicpurpura (ITP) who received intravenous immunoglobulin G (IVIG), megadose methylprednisolone (MDMP), or no therapy. Twenty-six children were observed with no therapy, 12 children received IVIG, and 12 children received MDMP. The percentage of the patients whose platelet counts increased at a level of > 20 x 10(9)/L and > 50 x 10(9)/L at 3 days after starting therapy was significantly higher in both IVIG and MDMP groups than in the no therapy group (p .05 in each comparison). This result suggested that therapy does not increase the rate of recovery but shortens the duration of thrombocytopenia in the first days. Management derision in ITP is made on clinical condition rather than on platelet count and no treatment options is to be preferred even in the face of mucosal bleeding. If the patient has extensive bleeding and the decision is to treat, both IVIG and MDMP are equally effective in providing a safe platelet level early on.
PubMed ID
12051587 View in PubMed
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[Differences in the treatment of idiopathic thrombocytopenic purpura in children].

https://arctichealth.org/en/permalink/ahliterature139150
Source
Ugeskr Laeger. 2010 Nov 22;172(47):3249-54
Publication Type
Article
Date
Nov-22-2010
Author
Pernille Wendtland Edslev
Mimi Kjaersgaard
Steen Rosthøj
Author Affiliation
Børneafdelingen, Århus Universitetshospital, Skejby, 8200 Århus N, Denmark. pernille@wendtland-edslev.dk
Source
Ugeskr Laeger. 2010 Nov 22;172(47):3249-54
Date
Nov-22-2010
Language
Danish
Publication Type
Article
Keywords
Adolescent
Child
Child, Preschool
Chronic Disease
Denmark
Disease Progression
Female
Follow-Up Studies
Humans
Immunoglobulins, Intravenous - therapeutic use
Infant
Male
Physician's Practice Patterns
Platelet Transfusion
Prospective Studies
Purpura, Thrombocytopenic, Idiopathic - drug therapy
Remission Induction
Treatment Outcome
Abstract
Idiopathic thrombocytopenic purpura (ITP) is a rare immune-mediated bleeding disorder that usually takes a self-limiting and benign course. Due to the risk of intracranial haemorrhage, treatment regimens tend to be active. We present treatment data from 17 paediatric departments in Denmark (1998-2000), focusing on regional differences in treatment strategy.
As part of a prospective Nordic study, clinical findings and treatment were recorded for 109 children with newly diagnosed ITP. The course in the following six months was reported for 91 children. Results are compared for three geographical regions: East, North and South.
Pharmacotherapy, almost exclusively intravenous immunoglobulin, was given within 14 days of diagnosis to 89%, 70%, and 48% in regions East, North, and South, respectively. A very low platelet count was the main indication. Platelet transfusion was given to 24%, 0% and 4%, respectively. There were no differences in remission rates or frequency of mucosal bleeding during follow-up, but treatment rates were 6.3, 4.7, and 3.0 per patient-year with severe thrombocytopenia. Chronic ITP lasting more than six months developed in 26%, 33%, and 18%, respectively.
We found obvious regional differences in treatment strategy which reflect differences in international clinical guidelines. The initial treatment approach had no influence on morbidity, time of remission or risk of chronic course.
PubMed ID
21092720 View in PubMed
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Evans syndrome: results of a national survey.

https://arctichealth.org/en/permalink/ahliterature207460
Source
J Pediatr Hematol Oncol. 1997 Sep-Oct;19(5):433-7
Publication Type
Article
Author
P. Mathew
G. Chen
W. Wang
Author Affiliation
Department of Pediatrics, Medical College of Ohio at Toledo, USA.
Source
J Pediatr Hematol Oncol. 1997 Sep-Oct;19(5):433-7
Language
English
Publication Type
Article
Keywords
Adolescent
Adrenal Cortex Hormones - therapeutic use
Adult
Anemia, Hemolytic - epidemiology - therapy
Azathioprine - therapeutic use
Canada
Child
Child, Preschool
Cyclophosphamide - therapeutic use
Cyclosporine - therapeutic use
Danazol - therapeutic use
Demography
Female
Humans
Immunoglobulins, Intravenous - therapeutic use
Infant
Male
Neutropenia
Pancytopenia
Plasmapheresis
Questionnaires
Recurrence
Splenectomy
Syndrome
Thrombocytopenia - epidemiology - therapy
United States
Vincristine - therapeutic use
Abstract
Our goal was to improve the management of Evans Syndrome, an uncommon and frequently refractory condition. We conducted a retrospective survey to assess the demography, presentation, clinical course, and treatment response of affected children.
Information was analyzed from a detailed questionnaire completed by pediatric hematologists mainly in the U.S. and Canada. We sought information regarding demographics, findings at presentation, approach to diagnosis, treatments used (with specific reference to splenectomy, corticosteroids, and intravenous immunoglobulin (IVIG)), course of the disease with emphasis on recurrences, and status at last follow-up.
Forty-two patients (22 male, 20 female) were included in the study. The median age was 7.7 years (range 0.2-26.6 years). At presentation, thrombocytopenia (32 patients) and anemia (28) were common; neutropenia occurred in 10 and pancytopenia in 6. Patients received a median of 5 (range 0-12) modalities of treatment. Courses of IVIG and corticosteroids were given to almost all patients; responses were varied but the effects lasted as long as 2 years. Splenectomy was performed for 15 patients but the median duration of response was only 1 month. Other treatments included cyclosporine, vincristine, danazol, azathioprine, cyclophosphamide, and plasmapheresis. The course of the disease was characterized by recurrent thrombocytopenia, hemolytic anemia, and neutropenia. After a median follow-up of 3 years, 3 patients had died, 20 had active disease on treatment, 5 had persistent disease (not on treatment), and 14 had no evidence of disease.
Evans syndrome is a chronic and recurrent condition which is often refractory to IVIG, corticosteroids, and splenectomy. Responses to other agents have been anecdotal and inconclusive. A prospective study involving these agents is needed to determine optimal therapeutic combinations.
Notes
Comment In: J Pediatr Hematol Oncol. 1999 May-Jun;21(3):248-910363861
PubMed ID
9329465 View in PubMed
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Guidelines on the use of intravenous immune globulin for hematologic conditions.

https://arctichealth.org/en/permalink/ahliterature164349
Source
Transfus Med Rev. 2007 Apr;21(2 Suppl 1):S9-56
Publication Type
Article
Date
Apr-2007
Author
David Anderson
Kaiser Ali
Victor Blanchette
Melissa Brouwers
Stephen Couban
Paula Radmoor
Lothar Huebsch
Heather Hume
Anne McLeod
Ralph Meyer
Catherine Moltzan
Susan Nahirniak
Stephen Nantel
Graham Pineo
Gail Rock
Author Affiliation
QEII Health Sciences Centre and Dalhousie University, Halifax, NS, Canada. david.anderson@dal.ca
Source
Transfus Med Rev. 2007 Apr;21(2 Suppl 1):S9-56
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Canada
Evidence-Based Medicine
Hematologic Diseases - drug therapy
Humans
Immunoglobulins, Intravenous - therapeutic use
Practice Guidelines as Topic
Substance-Related Disorders
Abstract
Canada's per capita use of intravenous immune globulin (IVIG) grew by approximately 115% between 1998 and 2006, making Canada one of the world's highest per capita users of IVIG. It is believed that most of this growth is attributable to off-label usage. To help ensure IVIG use is in keeping with an evidence-based approach to the practice of medicine, the National Advisory Committee on Blood and Blood Products of Canada (NAC) and Canadian Blood Services convened a panel of national experts to develop an evidence-based practice guideline on the use of IVIG for hematologic conditions. The mandate of the expert panel was to review evidence regarding use of IVIG for 18 hematologic conditions and formulate recommendations on IVIG use for each. A panel of 13 clinical experts and 1 expert in practice guideline development met to review the evidence and reach consensus on the recommendations for the use of IVIG. The primary sources used by the panel were 3 recent evidence-based reviews. Recommendations were based on interpretation of the available evidence and where evidence was lacking, consensus of expert clinical opinion. A draft of the practice guideline was circulated to hematologists in Canada for feedback. The results of this process were reviewed by the expert panel, and modifications to the draft guideline were made where appropriate. This practice guideline will provide the NAC with a basis for making recommendations to provincial and territorial health ministries regarding IVIG use management. Specific recommendations for routine use of IVIG were made for 7 conditions including acquired red cell aplasia; acquired hypogammaglobulinemia (secondary to malignancy); fetal-neonatal alloimmune thrombocytopenia; hemolytic disease of the newborn; HIV-associated thrombocytopenia; idiopathic thrombocytopenic purpura; and posttransfusion purpura. Intravenous immune globulin was not recommended for use, except under certain life-threatening circumstances, for 8 conditions including acquired hemophilia; acquired von Willebrand disease; autoimmune hemolytic anemia; autoimmune neutropenia; hemolytic transfusion reaction; hemolytic transfusion reaction associated with sickle cell disease; hemolytic uremic syndrome/thrombotic thrombocytopenic purpura; and viral-associated hemophagocytic syndrome. Intravenous immune globulin was not recommended for 2 conditions (aplastic anemia and hematopoietic stem cell transplantation) and was contraindicated for 1 condition (heparin-induced thrombocytopenia). For most hematologic conditions reviewed by the expert panel, routine use of IVIG was not recommended. Development and dissemination of evidence-based guidelines may help to facilitate appropriate use of IVIG.
PubMed ID
17397769 View in PubMed
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34 records – page 1 of 4.